Find my path

Beyond the Match

What happens to income after you start?

Salary tables describe people who trained years ago, in a market that may not be there when you finish. We make no salary predictions here. We show you what sets income, where you'll be when it matters, and how much room your plan has if it moves.

Step 1

Where will you actually be, 5 to 10 years from today?

  • College2026 to 2031
  • Medical school2031 to 2035
  • Residency and fellowship2035 to 2038
  • Independent practice2038 to beyond

From 2031 to 2036, you would be in medical school, then residency and fellowship. Your first full income would arrive around 2038 at the earliest, so you would be choosing a specialty before anyone can see what it pays once you finish.

This is calendar arithmetic assuming no gap years, not a prediction. Residency lengths are examples and vary by program.

Step 2

Six forces set what clinicians earn. All of them can move.

AI is not one force on income. It pushes on each of these separately, and sometimes in opposite directions. That's why a single prediction would be dishonest.

1 of 6

The price of each service

What will payers pay for the work?

  • Payers reward measurable outcomes, or policy ties updates to inflation.
  • Payers see AI doing part of a service and pay less for it, or the price falls as the work gets easier to deliver.
  • Medicare fee schedule rules, new billing codes for AI-assisted work, private payer contracts.
  • Established now

    Adjusted for inflation in practice costs, Medicare physician payment declined 33% from 2001 to 2026.

    What this does not prove: One payer's rates against practice costs, reported by a group that campaigns on the issue. Not take-home pay.

    American Medical Association, Updated January 2026

    Medicare Physician Updates Compared to Inflation in Practice Costs (2001-2026)

    Scope: U.S. Medicare physician payment updates, 2001 to 2026.

    How it was done: Federal payment updates compared with the Medicare Economic Index, a measure of practice costs.

    Limits: From a physician advocacy organization that campaigns on this issue. It measures one payer's rates against practice costs. It is not a measure of what physicians take home.

    Checked against the original on November 6, 2026.

    Open the source (opens in a new tab)

2 of 6

How much one clinician can do

If AI saves an hour, who keeps the hour?

  • Paid per service, a clinician who sees more patients in the same day can earn more.
  • Employers raise panel sizes without raising pay, or fewer clinicians cover the same patients.
  • Panel sizes, time-use studies, how employers change productivity targets.
  • Emerging

    Across multiple hospital systems, physicians reported up to 83% less time writing notes with AI scribes.

    What this does not prove: "Up to" is the top of a range and it is self-reported. Saved time is not the same as income.

    Stanford HAI, 2026

    The 2026 AI Index Report, Chapter 6: Medicine

    Scope: Global research, with U.S. data on FDA authorizations.

    How it was done: An annual review that summarizes studies by other researchers.

    Limits: A summary of studies with different designs. Each headline figure comes from one setup and does not generalize on its own.

    Checked against the original on November 6, 2026.

    Open the source (opens in a new tab)
  • Emerging

    Sharp HealthCare reported a 3.5% to 6% increase in work relative value units per encounter with AI scribes. At Northwestern Medicine, frequent users saw 11.3 more patients a month.

    What this does not prove: Hospital systems reporting their own results. This is a measure of output, which matters to pay only where pay follows output.

    Stanford HAI, 2026

    The 2026 AI Index Report, Chapter 6: Medicine

    Scope: Global research, with U.S. data on FDA authorizations.

    How it was done: An annual review that summarizes studies by other researchers.

    Limits: A summary of studies with different designs. Each headline figure comes from one setup and does not generalize on its own.

    Checked against the original on November 6, 2026.

    Open the source (opens in a new tab)

3 of 6

Who is allowed to do the work

What will require a physician's license, and for how long?

  • Accountability stays with licensed physicians, and each one oversees more care.
  • States and payers let other clinicians, or validated AI, do work that once required a physician.
  • State scope of practice laws, medical boards, payer policy, and any FDA authorization that removes a clinician from the loop.
  • Established now

    BLS projects 2025 to 2035 growth of 4% for physicians and surgeons, 21% for physician assistants, and 36% for nurse anesthetists, midwives and practitioners, against 3% for all occupations.

    What this does not prove: A projection of employment growth. It is not a forecast of pay, and the physician outlook does not mention AI. Each route's source is in the table below.

    U.S. Bureau of Labor Statistics, Last modified August 27, 2026

    Occupational Outlook Handbook: Physicians and Surgeons

    Scope: United States.

    How it was done: Federal employment and wage statistics. Pay is the May 2025 median, half earn more and half earn less. Growth is a 2025 to 2035 projection.

    Limits: A median across all ages, regions and employers, before tax. A projection, not a promise. It tells you nothing about one person's income. The outlook text on this page names aging and chronic illness as demand drivers, and does not mention AI.

    Checked against the original on November 6, 2026.

    Open the source (opens in a new tab)

4 of 6

How much care people need

Will cheaper, easier care mean more care or fewer visits?

  • An aging population, plus easier access that uncovers need nobody was treating.
  • Patients resolve more with AI at home, so there are fewer visits per person.
  • Visit rates, patient adoption, whether continuous monitoring adds care or replaces it.
  • Established now

    AAMC cites projected U.S. population growth of 8.4% by 2036, with the 65 and over group up 34.1% and the 75 and over group up 54.7%.

    What this does not prove: A demographic projection. How much of that need turns into physician work is the open question.

    Association of American Medical Colleges, March 21, 2024

    The Complexities of Physician Supply and Demand: Projections From 2021 to 2036

    Scope: United States, 2021 to 2036.

    How it was done: Scenario modeling by GlobalData Plc for the AAMC, conducted in 2023. The range runs from the 25th to the 75th percentile of supply adequacy across scenarios.

    Limits: Modeled before today's AI capabilities, and the report calls the effect of new technologies on supply and demand complex and unclear. The AAMC is also an interested party in workforce policy.

    Checked against the original on November 6, 2026.

    Open the source (opens in a new tab)

5 of 6

How many clinicians are trained

How many people are competing for the same work?

  • Residency slots stay limited while older physicians retire, so fewer people compete for the same work.
  • Training gets shorter or expands, and each trained clinician covers more patients.
  • Residency slots, retirement rates, new schools, competency-based programs.
  • Established now

    The 2026 Match offered a record 44,344 positions to a record 53,373 registered applicants.

    National Resident Matching Program, March 20, 2026

    Results of the 2026 Main Residency Match

    Scope: U.S. Main Residency Match, 2026.

    How it was done: NRMP's own count of applicants, positions and results.

    Limits: Shows who entered training in one year. It says nothing about what those careers will pay or look like a decade later.

    Checked against the original on November 6, 2026.

    Open the source (opens in a new tab)
  • Contested

    AAMC's projection runs from a shortage of 13,500 to one of 86,000 physicians by 2036, including 20,200 to 40,400 in primary care.

    What this does not prove: Modeled in 2023. The low and high ends differ more than sixfold, and the report calls the effect of new technology complex and unclear. A shortage model is not a pay guarantee.

    Association of American Medical Colleges, March 21, 2024

    The Complexities of Physician Supply and Demand: Projections From 2021 to 2036

    Scope: United States, 2021 to 2036.

    How it was done: Scenario modeling by GlobalData Plc for the AAMC, conducted in 2023. The range runs from the 25th to the 75th percentile of supply adequacy across scenarios.

    Limits: Modeled before today's AI capabilities, and the report calls the effect of new technologies on supply and demand complex and unclear. The AAMC is also an interested party in workforce policy.

    Checked against the original on November 6, 2026.

    Open the source (opens in a new tab)

6 of 6

Where the value moves

Will income follow the license, or whoever owns the system?

  • Clinicians who own practices, supervise AI or build tools capture part of the gains.
  • Gains flow to employers and vendors, while clinicians become salaried supervisors.
  • Physician ownership and employment trends, vendor consolidation, new hybrid job titles.
  • Unknown

    We have no reliable data yet on how AI changes the split of income between clinicians, employers and technology companies.

Step 3

How income could play out in each future

Constrained adoption

Today's income structure mostly holds. The pressures that already exist, such as payment rates and practice costs, matter more than AI does.

Accelerated augmentation

This is where income is hardest to call. Higher capacity could raise earnings for clinicians paid by volume or lower them where employers and payers capture the gains, and it may split widely by specialty and ownership.

Broad autonomy

Substantial displacement in some roles is possible, along with lower prices and wider access for patients. Heavy debt tied to one income assumption is the most exposed position in this future.

Scenarios with no dollar figures and no probabilities on purpose. See what each one assumes.

Step 4

Your debt is a fixed number. Your income isn't.

So test the plan where it could break. Enter your own numbers.

When repayment starts

$3,101 /month

On a balance of $254,692, paid off in 10 years, for $372,107 in total.

Yearly loan payments as a share of pre-tax income at four income levels
If income isPre-tax incomeGoes to loans
20% higher$293,01613%
As you expect$244,18015%
20% lower$195,34419%
40% lower$146,50825%

For new borrowers, this is above the $200,000 federal limit. The rest may have to come from savings, scholarships or private loans, and a private loan's rate and protections can differ.

The income changes are test points we picked, not predictions. This is a level 10-year payment for comparing situations. Real federal plans can tie payments to income, and forgiveness programs can change the total. Shares are before taxes and living costs. Math check: at $205,000, three years of training and 8.08%, this gives about $3,100 a month, the same as the AAMC's published example.

Changed in 2026

Federal loans changed, and a lot of advice hasn't caught up.

For many students starting now, federal loans may not cover the full cost of medical school. This matters whichever future arrives.

  • Established now

    Grad PLUS, which let students borrow up to the full cost of attendance, ended for new borrowers on July 1, 2026.

    What this does not prove: Borrowers already enrolled with a federal loan by June 30, 2026 may keep it for up to three academic years.

    Association of American Medical Colleges, Updated July 21, 2026

    AAMC Analysis: Education Department Final Rule on Student Aid Reforms

    Scope: U.S. federal student loans, under Public Law 119-21.

    How it was done: The AAMC's reading of the May 1, 2026 final rule from the Department of Education.

    Limits: A summary, not legal or financial advice. Rules can change, and a borrower's exact position depends on when they first borrowed.

    Checked against the original on November 6, 2026.

    Open the source (opens in a new tab)
  • Established now

    Federal loans for a professional degree such as medicine are now limited to $50,000 a year and $200,000 in total, with a $257,500 lifetime federal limit.

    What this does not prove: The $200,000 includes earlier graduate borrowing. Anything beyond the limits needs other funding, which may mean private loans.

    Association of American Medical Colleges, Updated July 21, 2026

    AAMC Analysis: Education Department Final Rule on Student Aid Reforms

    Scope: U.S. federal student loans, under Public Law 119-21.

    How it was done: The AAMC's reading of the May 1, 2026 final rule from the Department of Education.

    Limits: A summary, not legal or financial advice. Rules can change, and a borrower's exact position depends on when they first borrowed.

    Checked against the original on November 6, 2026.

    Open the source (opens in a new tab)
  • Established now

    Median four-year cost of attendance for the Class of 2025 was $286,454 at public and $390,848 at private medical schools, for in-state students.

    What this does not prove: Medians, and your school can differ a lot. The gap between these costs and the federal limit is the new planning problem.

    Association of American Medical Colleges, October 2024

    Medical Student Education: Debt, Costs, and Loan Repayment Fact Card for the Class of 2024

    Scope: U.S. MD graduates. Costs are in-state medians from 94 public and 64 private schools.

    How it was done: AAMC 2024 Graduation Questionnaire and Tuition and Student Fees Questionnaire.

    Limits: A newer Class of 2026 card exists behind the AAMC store checkout, and we have not read it yet. The repayment examples on this edition predate the 2026 federal loan changes.

    Checked against the original on November 6, 2026.

    Open the source (opens in a new tab)
  • Established now

    In the Class of 2024, 71% of MD graduates had education debt, with a median of $205,000 among those who had it. 23% owed $300,000 or more.

    What this does not prove: These graduates borrowed under the old rules, and the figure includes premedical debt.

    Association of American Medical Colleges, October 2024

    Medical Student Education: Debt, Costs, and Loan Repayment Fact Card for the Class of 2024

    Scope: U.S. MD graduates. Costs are in-state medians from 94 public and 64 private schools.

    How it was done: AAMC 2024 Graduation Questionnaire and Tuition and Student Fees Questionnaire.

    Limits: A newer Class of 2026 card exists behind the AAMC store checkout, and we have not read it yet. The repayment examples on this edition predate the 2026 federal loan changes.

    Checked against the original on November 6, 2026.

    Open the source (opens in a new tab)
  • Established now

    The median first-year resident stipend in 2024 was $65,100 (preliminary), which is what you live on while interest can run.

    Association of American Medical Colleges, October 2024

    Medical Student Education: Debt, Costs, and Loan Repayment Fact Card for the Class of 2024

    Scope: U.S. MD graduates. Costs are in-state medians from 94 public and 64 private schools.

    How it was done: AAMC 2024 Graduation Questionnaire and Tuition and Student Fees Questionnaire.

    Limits: A newer Class of 2026 card exists behind the AAMC store checkout, and we have not read it yet. The repayment examples on this edition predate the 2026 federal loan changes.

    Checked against the original on November 6, 2026.

    Open the source (opens in a new tab)

Today's baseline

What people earn right now, and other routes to the same mission

A May 2025 snapshot from the U.S. Bureau of Labor Statistics. It tells you where things stand, not where they will be when you get there. Compare routes on what you want from your work. We don't rank them.

Physician or surgeon (MD, DO)

U.S. Bureau of Labor Statistics, Last modified August 27, 2026

Occupational Outlook Handbook: Physicians and Surgeons

Scope: United States.

How it was done: Federal employment and wage statistics. Pay is the May 2025 median, half earn more and half earn less. Growth is a 2025 to 2035 projection.

Limits: A median across all ages, regions and employers, before tax. A projection, not a promise. It tells you nothing about one person's income. The outlook text on this page names aging and chronic illness as demand drivers, and does not mention AI.

Checked against the original on November 6, 2026.

Open the source (opens in a new tab)

Doctoral degree, then residency of 3 or more years

Direct, with the final accountability today

Median pay: $275,930

Projected growth: 4%

Nurse anesthetist, midwife, practitioner

U.S. Bureau of Labor Statistics, Last modified October 29, 2026

Occupational Outlook Handbook: Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners

Scope: United States.

How it was done: Federal employment and wage statistics. Pay is the May 2025 median, half earn more and half earn less. Growth is a 2025 to 2035 projection.

Limits: A median across all ages, regions and employers, before tax. A projection, not a promise. It tells you nothing about one person's income.

Checked against the original on November 6, 2026.

Open the source (opens in a new tab)

Master's degree, after nursing licensure

Direct

Median pay: $134,920

Projected growth: 36%

Physician assistant

U.S. Bureau of Labor Statistics, Last modified August 27, 2026

Occupational Outlook Handbook: Physician Assistants

Scope: United States.

How it was done: Federal employment and wage statistics. Pay is the May 2025 median, half earn more and half earn less. Growth is a 2025 to 2035 projection.

Limits: A median across all ages, regions and employers, before tax. A projection, not a promise. It tells you nothing about one person's income.

Checked against the original on November 6, 2026.

Open the source (opens in a new tab)

Master's degree

Direct

Median pay: $135,880

Projected growth: 21%

Registered nurse

U.S. Bureau of Labor Statistics, Last modified October 29, 2026

Occupational Outlook Handbook: Registered Nurses

Scope: United States.

How it was done: Federal employment and wage statistics. Pay is the May 2025 median, half earn more and half earn less. Growth is a 2025 to 2035 projection.

Limits: A median across all ages, regions and employers, before tax. A projection, not a promise. It tells you nothing about one person's income.

Checked against the original on November 6, 2026.

Open the source (opens in a new tab)

Bachelor's degree is the most common

Direct, and the most hours at the bedside

Median pay: $97,550

Projected growth: 6%

Medical scientist

U.S. Bureau of Labor Statistics, Last modified October 29, 2026

Occupational Outlook Handbook: Medical Scientists

Scope: United States.

How it was done: Federal employment and wage statistics. Pay is the May 2025 median, half earn more and half earn less. Growth is a 2025 to 2035 projection.

Limits: A median across all ages, regions and employers, before tax. A projection, not a promise. It tells you nothing about one person's income.

Checked against the original on November 6, 2026.

Open the source (opens in a new tab)

Doctoral or professional degree

Some, in clinical research

Median pay: $103,410

Projected growth: 13%

Biomedical engineer

U.S. Bureau of Labor Statistics, Last modified August 27, 2026

Occupational Outlook Handbook: Bioengineers and Biomedical Engineers

Scope: United States.

How it was done: Federal employment and wage statistics. Pay is the May 2025 median, half earn more and half earn less. Growth is a 2025 to 2035 projection.

Limits: A median across all ages, regions and employers, before tax. A projection, not a promise. It tells you nothing about one person's income.

Checked against the original on November 6, 2026.

Open the source (opens in a new tab)

Bachelor's degree

Little, you build what clinicians use

Median pay: $109,370

Projected growth: 8%

Epidemiologist

U.S. Bureau of Labor Statistics, Last modified August 27, 2026

Occupational Outlook Handbook: Epidemiologists

Scope: United States.

How it was done: Federal employment and wage statistics. Pay is the May 2025 median, half earn more and half earn less. Growth is a 2025 to 2035 projection.

Limits: A median across all ages, regions and employers, before tax. A projection, not a promise. It tells you nothing about one person's income.

Checked against the original on November 6, 2026.

Open the source (opens in a new tab)

Master's degree

Little, you protect whole populations

Median pay: $87,220

Projected growth: 19%

All occupations: $50,980 median pay and 3% projected growth. We have not yet verified the cost of each non-physician program, so compare those school by school. Starting later with less debt, or starting sooner with less pay: only you can weigh that.

Physician medians by specialty, May 2025

  • Pediatricians, general$210,040
  • Family medicine physicians$244,180
  • Psychiatrists$281,870
  • Pathologists$312,400
  • Anesthesiologists$391,490
  • Surgeons, all other$414,010
  • Radiologists$420,860
  • Cardiologists$496,010
U.S. Bureau of Labor Statistics, Last modified August 27, 2026

Occupational Outlook Handbook: Physicians and Surgeons

Scope: United States.

How it was done: Federal employment and wage statistics. Pay is the May 2025 median, half earn more and half earn less. Growth is a 2025 to 2035 projection.

Limits: A median across all ages, regions and employers, before tax. A projection, not a promise. It tells you nothing about one person's income. The outlook text on this page names aging and chronic illness as demand drivers, and does not mention AI.

Checked against the original on November 6, 2026.

Open the source (opens in a new tab)

This year

Six things to do. All cheap, all reversible.

  1. 1Write down the income you are quietly assuming, and where that number came from.
  2. 2Run the stress test below with your real school's cost, then ask what you would do at 40% lower.
  3. 3Ask three physicians five to ten years into practice what their week looks like and who sets their pay.
  4. 4Ask one financial aid office how it fills the gap above the $200,000 federal limit, before you apply.
  5. 5Pick one non-physician route and shadow it for a day, even if you stay on your current path.
  6. 6Put a date on your calendar twelve months out to reread your assumptions.
Jobs, shortages and wages Training, time and debt Careers beyond physician

Sources last checked November 6, 2026

Next review by February 6, 2027.

What changed, and how we decide

Career guidance, not medical, legal or financial advice. For a major loan or licensing decision, talk with a qualified professional, and bring your questions from here.

Do you disagree?

If you have counterevidence, or we got something wrong, we want to see it. Don't take our word for any of this.

Send us the evidence